内容紹介
Summary
We report a case of breast cancer with cartilaginous differentiation that responded well to chemotherapy, which completely eliminated distant metastasis. A 63-year-old woman visited our hospital complaining of a large hemorrhagic mass measuring 15 cm in diameter with ulceration of the left breast. Palpation revealed swelling of the left axillary and right supraclavicular(SC)lymph nodes, suggesting breast cancer metastasis. A CT scan revealed metastasis in the right lung measuring 2.5 cm in size. She underwent a total mastectomy with axillary dissection. The pathological findings were as follows; breast carcinoma with cartilaginous differentiation accompanied by a single lymph node metastasis(1/21)and skin involvement, ly0, v0, ER(-), PgR(-), HER2 0, Ki-67 80%. Four courses of AC therapy were administered as postoperative chemotherapy, which resulted in a decrease in the size of the SC lymph node to 1 cm. Subsequently, 12 courses of weekly paclitaxel yielded a complete response of the lung and SC lymph node metastasis. Oral administration of S-1 after paclitaxel therapy resulted in no recurrence for 16 months after the operation.
要旨
症例は63歳,女性。左乳房に潰瘍形成を伴う易出血性15 cm大の腫瘤を認めた。3 cm程度に腫大した左腋窩リンパ節,右鎖骨上リンパ節を触知した。造影CTで右肺に2.5 cmの不整形腫瘍を認め,肺転移が疑われた。局所コントロールのため,左乳房切除術のみを施行した。病理学的所見は骨・軟骨化生を伴う乳癌,n=1/21,s(+),ly0,v1,NG3,Ki-67 80%,ER(-),PgR(-),HER2 0であった。術後は,adriamycin+cyclophosphamide(AC)療法を4コース施行し,右鎖骨上リンパ節は1 cmまで縮小した。継続してweekly paclitaxel(PTX)を12コース施行し,右鎖骨上リンパ節および肺転移はcomplete response(CR)となったためPTXを終了した。維持療法としてS-1を投与し,16か月以上CRを維持している。化学療法により遠隔転移がCRとなった骨・軟骨化生を伴う乳癌の1例を経験したので,文献的考察を加えて報告する。
目次
We report a case of breast cancer with cartilaginous differentiation that responded well to chemotherapy, which completely eliminated distant metastasis. A 63-year-old woman visited our hospital complaining of a large hemorrhagic mass measuring 15 cm in diameter with ulceration of the left breast. Palpation revealed swelling of the left axillary and right supraclavicular(SC)lymph nodes, suggesting breast cancer metastasis. A CT scan revealed metastasis in the right lung measuring 2.5 cm in size. She underwent a total mastectomy with axillary dissection. The pathological findings were as follows; breast carcinoma with cartilaginous differentiation accompanied by a single lymph node metastasis(1/21)and skin involvement, ly0, v0, ER(-), PgR(-), HER2 0, Ki-67 80%. Four courses of AC therapy were administered as postoperative chemotherapy, which resulted in a decrease in the size of the SC lymph node to 1 cm. Subsequently, 12 courses of weekly paclitaxel yielded a complete response of the lung and SC lymph node metastasis. Oral administration of S-1 after paclitaxel therapy resulted in no recurrence for 16 months after the operation.
要旨
症例は63歳,女性。左乳房に潰瘍形成を伴う易出血性15 cm大の腫瘤を認めた。3 cm程度に腫大した左腋窩リンパ節,右鎖骨上リンパ節を触知した。造影CTで右肺に2.5 cmの不整形腫瘍を認め,肺転移が疑われた。局所コントロールのため,左乳房切除術のみを施行した。病理学的所見は骨・軟骨化生を伴う乳癌,n=1/21,s(+),ly0,v1,NG3,Ki-67 80%,ER(-),PgR(-),HER2 0であった。術後は,adriamycin+cyclophosphamide(AC)療法を4コース施行し,右鎖骨上リンパ節は1 cmまで縮小した。継続してweekly paclitaxel(PTX)を12コース施行し,右鎖骨上リンパ節および肺転移はcomplete response(CR)となったためPTXを終了した。維持療法としてS-1を投与し,16か月以上CRを維持している。化学療法により遠隔転移がCRとなった骨・軟骨化生を伴う乳癌の1例を経験したので,文献的考察を加えて報告する。